Flu or Flu-like illness in chronically ill or disabled children

Managing flu or flu-like illness at home

The parents we spoke to tried various ways to manage their child’s flu or flu-like illness symptoms at home. Sometimes children did not need to see a doctor or go to hospital and were able to be looked after at home for the whole illness.
Treating flu or flu-like illness symptoms

Generally a temperature of over 37.5C (99F) is considered a fever. Parents treated their child’s fever with paracetamol (aged over two months old) or ibuprofen (aged over three months old). The NHS Choices website has advice about giving paracetamol and ibuprofen to children. Parents are advised to check with their pharmacist that they have the correct dosage and strength for their child and that they follow the dosage instructions carefully. Oscar can only take paracetamol because he is also taking warfarin. Giving medicine in a syringe was easier for younger children. Damien is able to give Matias his medicines and fluids through his percutaneous endoscopic gastrostomy (PEG) feeding tube.
It is important that children have plenty of fluids when they have flu or flu-like illness. Sometimes parents of younger children said that their child did not want to drink. Louise’s son who has diabetes doesn’t always want to drink or eat when he is sick, which is a problem when he needs to take insulin. Fiona was breastfeeding her daughter so she knew she was getting enough fluids.
Some parents gave over the counter cough mixtures which they said soothed their children’s sore throats and helped their coughs or made warm lemon and honey drinks.

Parents said they also encouraged their child to rest, and they tried to keep them warm and comfortable. Tristan has a rest from daily physiotherapy. Karen says Alex has ‘boundless energy’ even when he is ill but she tries to make him rest more than normal. Some parents said they put extra pillows on their child’s bed at night to help with congestion. 

A warm, moist atmosphere can ease breathing if children have a blocked nose. Parents said that warm steam baths were effective and some put a few drops of eucalyptus oil or eucalyptus salts in the child’s bath. 

Anita found that cold air helped 2 year old Oliver to breathe better when his nose was blocked.
Some parents of children aged 6 years and over gave decongestant medicines, which they said helped them to feel more comfortable and improve their breathing. Other parents had used decongestant medicines and said they hadn’t made any difference to their children’s symptoms. The NHS Choices website advises that decongestants should not be given to children under six years old and should only be used by children aged 6-12 on the advice of a GP or pharmacist. 

Some parents said they gave their children vitamins or Echinacea (a herbal remedy) during illness to boost their immune system. There is no research evidence to show there are benefits from taking vitamins, such as Vitamin C, or Echinacea during flu-like illness. The NHS Choices website advises that children under 12 years old should not be given Echinacea.
Eliza has chronic heart failure. She experiences earache usually as a complication of flu or flu-like illness. Her mum says she has been so unwell throughout her life that now when she gets flu-like illness she is very stoic. Paracetamol and fluids are used to relieve her symptoms.

Treatment for the long term medical condition during influenza or flu-like illness

For most parents, management of their child’s underlying condition during flu or flu-like illness was crucial in ensuring they did not become seriously ill.
Following the advice of the asthma nurse or GP, parents of children with asthma increased their child’s medication, usually at any sign of a cold. This helps to reduce the asthma symptoms if they develop flu or flu-like illness.
Monitoring

Parents said they frequently monitored their child’s symptoms to make sure they were not becoming worse. Most parents had a thermometer to do this. Maria doesn’t use a thermometer but gauges how well her ten year old daughter is by what she says, how hot she feels and if she starts vomiting. Parents of children with diabetes said they frequently monitored their child’s ketones to make sure they were not developing diabetes ketoacidosis.
Through the night, parents would often sleep in the same room as their child so that they could continue to monitor them. Ruth has a child monitor device in her child’s room and her husband sleeps in the same room as her when she is ill. Like some of the other parents we spoke to, Ruth doesn’t sleep much at night when her daughter is ill, she says, “no-one really sleeps and it’s really stressful.” Mirella sleeps on a mattress in her son’s bedroom and sets an alarm every four hours to give him his inhaler through the night.
Parents said monitoring got easier when their child was older and they could tell them how they were feeling. Sharon uses a 1-10 scale with her 10 year old son who has asthma to find out how his chest is feeling. Ten year old Jade rests in her parent’s bedroom downstairs during the day when she is ill so that her mum can keep a close eye on her and talk to her about how she is feeling. 

Parents who had experienced several episodes of flu-like illness became more confident in knowing how best to manage their child’s symptoms at home.
Parents worked hard to keep their child at home for as long as possible but sometimes they decided they needed to get medical help.
See ‘Deciding when to get medical help’.

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